Abstract

With breech presentation, firstly is attempted the attribution of size of difficulty of implementation of vaginal delivery of a fetus that presents to the birth canal with buttocks or feet first. This is achieved by introducing and describing the required varying and heavy manipulations for vaginal delivery of a fetus with breech presentation-particularly the total breech extraction, by commenting the role of external version and caesarean section in resolving the occurring problems and dilemmas at this childbirth, by reporting the complications of all these medical interventions and techniques, and finally by mentioning the high risk of fetal and maternal morbidity and mortality. Moreover an extensive review of the studies and reports on the way of treatment of the breech presentation is attempted, as well as the applied protocols in various countries and institutions, and the established criteria for the choice of the type of delivery. The randomized prospective studies supporting these decisions are few and controversial, while the official clinical guidelines and consultations are insufficient and non-homogeneous.
Finally, the parameter of education, the experience and the technical skill of the obstetrician in the execution of the requisite manoeuvres for vaginal breech delivery is imported as critical and decisive criterion for the implementation or reject of these deliveries.

Key words: breech delivery; breech presentation; footling breech; frank breech; spontaneous breech; partial breech extraction; total breech extraction; external version.